Author(s): Nedasadat Mansouritehrani
Currently, various methods are being used for determining difficult
laryngoscopy. The present study aimed to compare the acromioaxillosuprasternal notch
index function with the old head and neck anatomic criteria in predicting difficult
laryngoscopy with respect to trachea intubation under general anesthesia in children.
Materials and Methods:
In this cross-sectional study, 379 children under intubation
with general anesthesia entered the study. Patients were divided into two groups: easy
laryngoscopy (grades 1 and 2) and difficult laryngoscopy (grades 3 and 4) based on
Cormack-Lehane score. The thyromental distance systems, height to thyromental
distance, Upper-Lip-Bite test, neck circumference, and acromioaxillosuprasternal
notch index were studied and compared.
Laryngoscopy was difficult in 48
subjects (38 were grade 3 and 10 were grade 4). Interestingly, no significant difference
was detected between easy and difficult laryngoscopies based on the thyromental
distance, neck circumference, height to thyromental distance, and acromioaxillosu-
prasternal notch index (P>0.05). height to thyromental distance , acromioaxillosu-
prasternal notch index , and neck circumference have a sensitivity of 32.2%, 47.9%,
51.1%, respectively, and the specificity was 52.7%, 45.6%, and 48.9%, respectively.
Neck circumference and acromioaxillosuprasternal notch index outper-
form the height to thyromental distance. On the other hand, Modified Mallampati test
is better than Upper-Lip-Bite test in determining difficult laryngoscopy in children.